Journal of Traditional Medical Complementary Therapies

.: ORIGINAL RESEARCH
Kronik Bel Ağrısı Bulunan Ofis Çalışanlarında Enstrüman Destekli Yumuşak Doku Mobilizasyonunun Eklem Hareket Açıklığı, Ağrı, Uyku ve Yaşam Kalitesi Üzerine Etkileri: Randomize Kontrollü Bir Çalışma
Effects of Instrument Assisted Soft Tissue Mobilisation on Range of Motion, Pain, Sleep and Quality of Life in Office Workers with Chronic Low Back Pain: A Randomized Controlled Trial
Onur KALAYCIa , Mustafa Savaş TORLAKb , Emine ATICIc
aİstanbul Okan Üniversitesi Lisansüstü Eğitim Enstitüsü, Fizyoterapi ve Rehabilitasyon AD Yüksek Lisans Programı, İstanbul, Türkiye
bKTO Karatay Üniversitesi Sağlık Hizmetleri Meslek Yüksekokulu, Terapi ve Rehabilitasyon Bölümü, Konya, Türkiye
cİstanbul Okan Üniversitesi Sağlık Bilimleri Fakültesi, Fizyoterapi ve Rehabilitasyon Bölümü, İstanbul, Türkiye
J Tradit Complem Med. 2024;7(3):253-62
doi: 10.5336/jtracom.2024-104332
Article Language: TR
Full Text
ÖZET
 Amaç: Bu çalışmanın amacı, kronik bel ağrısı bulunan ofis çalışanlarında enstrüman destekli yumuşak doku mobilizasyonunun (EDYDM) eklem hareket açıklığı, ağrı, uyku ve yaşam kalitesi üzerine etkilerini incelemektir. Gereç ve Yöntemler: Çalışmaya 30-50 yaş arasında kronik bel ağrısı yaşayan 17'si kadın ve 17'si erkek olmak üzere 34 ofis çalışanı gönüllü katılım sağladı. Katılımcılar randomize EDYDM (n=17) ve plasebo gruplarına (n=17) ayrıldı. Her iki gruba da 4 hafta sürecinde haftada 2 defa EDYDM uygulandı. Plasebo grubuna enstrümanların dokulara hiçbir etkisi olmayan yüzleri ile uygulama yapıldı. Katılımcıların demografik özellikleri olgu rapor formu ile toplandı. Uygulama öncesinde ve sonrasında katılımların ağrı şiddeti için Sayısal Ağrı Ölçeği (SAÖ) ve engellilik tespiti için Oswestry Bel Ağrısı Engellilik Anketi, uyku kalitesini ölçmek için Pittsburgh Uyku Kalitesi İndeksi (PUKİ) ve yaşam kalitesini belirlemek için SF36 Yaşam Kalitesi İndeksi uygulandı. Ayrıca akıllı telefonla lomber normal eklem hareket açıklığı ölçümleri yapıldı. Bulgular: EDYDM grubunda plasebo grubuna göre eklem hareket açıklığı, SAÖ, PUKİ, SF-36 değerlerinde istatistiksel açıdan fark vardı (p<0,05). Plasebo grubunda tedavi öncesine göre tedavi sonrasında eklem hareket açıklığı, SAÖ, PUKİ, bel fonksiyonu, SF-36 değerlerinde anlamlı fark vardı (p<0,05). Araştırma sonucunda, kronik bel ağrılı bireylerde EDYDM uygulamasının eklem hareket açıklığını, uyku ve yaşam kalitesini artırdığı, ağrı şiddetini azalttığı saptandı. Ayrıca EDYDM'nin SAÖ, PUKİ, Oswestry ve SF-36 anketlerine göre plasebo etkisinin olduğu gözlemlendi. Sonuç: Kronik bel ağrısı bulunan ofis çalışanlarında EDYDM'nin eklem hareket açıklığı, ağrı, uyku ve yaşam kalitesi üzerine olumlu etkilerinin olduğu belirlendi.

Anahtar Kelimeler: Bel ağrısı; fizik tedavi modaliteleri; uyku; yaşam kalitesi; yumuşak doku mobilizasyonu
ABSTRACT
 Objective: The aim of this study was to investigate the effects of instrument-assisted soft tissue mobilisation (IASM) on range of motion, pain, sleep and quality of life in office workers with chronic low back pain. Material and Methods: Thirty-four office workers (17 female and 17 male) aged 30-50 years with chronic low back pain participated voluntarily in the study. Participants were randomly divided into IASM (n=17) and placebo groups (n=17). Both groups received IASM twice a week for 4 weeks. The placebo group was treated with the faces of the instruments that had no effect on the tissues. Demographic characteristics of the participants were collected with a case report form. Before and after the application, a Numerical Pain Scale (NPS) was applied for pain intensity and Oswestry Low Back Pain Disability Questionnaire for disability determination, Pittsburgh Sleep Quality Index (PSQI) for sleep quality, and SF-36 Quality of Life Index for quality of life. In addition, lumbar normal range of motion measurements were performed with a smartphone. Results: In the IASM group, there was a statistically significant difference in range of motion, NPS, PSQI and SF36 values compared to the placebo group (p<0.05). In the placebo group, there was a significant difference in range of motion, NPS, PSQI, lumbar function, SF-36 values after treatment compared to pre-treatment (p<0.05). As a result of the study, it was found that IASM application increased range of motion, sleep and quality of life and decreased pain severity in individuals with chronic low back pain. In addition, it was observed that IASM had a placebo effect according to NPS, PSQI, Oswestry and SF-36 questionnaires. Conclusion: IASM had positive effects on range of motion, pain, sleep and quality of life in office workers with chronic low back pain.

Keywords: Low back pain; physical therapy modalities; sleep; quality of life; soft tissue mobilization
REFERENCES:
  1. Kim N, Yang B, Lee T, Kwon S. An economic analysis of usual care and acupuncture collaborative treatment on chronic low back pain: a Markov model decision analysis. BMC Complement Altern Med. 2010;10:74. [Crossref]  [PubMed]  [PMC] 
  2. Janwantanakul P, Pensri P, Moolkay P, Jiamjarasrangsi W. Development of a risk score for low back pain in office workers--a cross-sectional study. BMC Musculoskelet Disord. 2011;12:23. [Crossref]  [PubMed]  [PMC] 
  3. Rodriguez-Blanco T, Fernández-San-Martin I, Balagué-Corbella M, Berenguera A, Moix J, Montiel-Morillo E, et al. Study protocol of effectiveness of a biopsychosocial multidisciplinary intervention in the evolution of non-specific sub-acute low back pain in the working population: cluster randomised trial. BMC Health Serv Res. 2010;10:12. [Crossref]  [PubMed]  [PMC] 
  4. Laudner K, Compton BD, McLoda TA, Walters CM. Acute effects of instrument assisted soft tissue mobilization for improving posterior shoulder range of motion in collegiate baseball players. Int J Sports Phys Ther. 2014;9(1):1-7. [PubMed]  [PMC] 
  5. Narin S, Bozan Ö, Cankurtaran F, Bakırhan S. Kronik bel ağrılı hastalarda fizyoterapi programının fonksiyonel kapasite ve yaşam kalitesi üzerine etkisi [The effects of physiotherapy program on the functional capacity and the quality of life in patients with chronic low back pain]. Dokuz Eylül Üniversitesi Tıp Fakültesi Dergisi. 2008;22(3):137-43. [Link] 
  6. Loghmani MT, Warden SJ. Instrument-assisted cross fiber massage increases tissue perfusion and alters microvascular morphology in the vicinity of healing knee ligaments. BMC Complement Altern Med. 2013;13:240. [Crossref]  [PubMed]  [PMC] 
  7. Lee JH, Lee DK, Oh JS. The effect of Graston technique on the pain and range of motion in patients with chronic low back pain. J Phys Ther Sci. 2016;28(6):1852-5. [Crossref]  [PubMed]  [PMC] 
  8. Kalaycıoğlu O, Akhanlı SE. Sağlık araştırmalarında güç analizinin önemi ve temel prensipleri: tıbbi çalışmalar üzerinde uygulamalı örnekler [The importance and main principles of power analysis in health research: application examples on medical case studies]. Turkish Journal of Public Health. 2020;18(1):103-12. [Crossref] 
  9. Jensen MP, McFarland CA. Increasing the reliability and validity of pain intensity measurement in chronic pain patients. Pain. 1993;55(2):195-203. [Crossref]  [PubMed] 
  10. Vianin M. Psychometric properties and clinical usefulness of the Oswestry Disability Index. J Chiropr Med. 2008;7(4):161-3. [Crossref]  [PubMed]  [PMC] 
  11. Buysse DJ, Reynolds CF 3rd, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989;28(2):193-213. [Crossref]  [PubMed] 
  12. Ağargün MY, Kara H, Anlar O. Pittsburgh Uyku Kalitesi İndeksinin geçerliği ve güvenirliği [Validity and reliability of the Pittsburgh Sleep Quality Index]. Türk Psikiyatri Dergisi. 1996;7:107-15. [Link] 
  13. Ware JE Jr, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992;30(6):473-83. [Crossref]  [PubMed] 
  14. Koçyiğit H, Aydemir Ö, Ölmez N, Memiş A. Kısa form-36 (KF36)'nın Türkçe versiyonunun güvenirliliği ve geçerliliği [Reliability and validity of the turkish version of Short Form-36 (SF-36)]. İlaç ve Tedavi Dergisi. 1999;12(2):102-6. [Link] 
  15. Gulick DT. Instrument-assisted soft tissue mobilization increases myofascial trigger point pain threshold. J Bodyw Mov Ther. 2018;22(2):341-5. [Crossref]  [PubMed] 
  16. Yıldırım A. Lomber bölge disk herniasyonlarında alet yardımlı yumuşak doku mobilizasyonunun etkinliği [Yüksek lisans tezi]. İstanbul: Bezmialem Vakıf Üniversitesi; 2019. Erişim tarihi: 25.05.2024. Erişim linki: [Link] 
  17. Weber P, Klingler W, Schleip R, Weber N, Joisten C. The Influence of a Single Instrument-Assisted Manual Therapy (IAMT) for the lower back on the structural and functional properties of the dorsal myofascial chain in female soccer players: a randomised, placebo-controlled trial. J Clin Med. 2022;11(23):7110. [Crossref]  [PubMed]  [PMC] 
  18. Moon JH, Jung JH, Won YS, Cho HY. Immediate effects of Graston Technique on hamstring muscle extensibility and pain intensity in patients with nonspecific low back pain. J Phys Ther Sci. 2017;29(2):224-7. [Crossref]  [PubMed]  [PMC] 
  19. Çakmak Ö, Atıcı E, Gülşen M. The effects of instrument-assisted soft tissue mobilization and kinesio taping on pain, functional disability and depression in patients with chronic low back pain: a randomized trial. Türk Fizyoterapi ve Rehabilitasyon Dergisi. 2022;33(3):179-86. [Crossref] 
  20. Erdal R, Telli Atalay O, Altuğ F, Türkmen B, Çıtışlı V, Baskan E. Kronik bel ağrısı olan olgularda fizik tedavi ve rehabilitasyonun ağrı özürlülük depresif bulgular ve uyku kalitesi üzerine etkisi [The effects of physical therapy and rehabilitation on pain, disability, depressive symptoms and sleep quality of subjects with chronic back pain]. Abant Tıp Dergisi. 2017;6(3):86-92. [Crossref] 
  21. Atılgan E, Erbahçeci F. Kronik bel ağrılı bireylerde yoga ve fizyoterapi programının yaşam kalitesi, denge, ağrı düzeyi ve uyku kalitesi üzerine etkilerinin karşılaştırılması [Comparison of the effects of yoga and physiotherapy program on quality of life, balance, pain level, and sleep quality in individuals with chronic low back pain]. Journal of Exercise Therapy and Rehabilitation. 2018;5(3):158-66. [Link] 
  22. Çıbık M, Torlak MS. Kronik miyofasiyal boyun ağrısı olan hastalarda enstrüman destekli yumuşak doku mobilizasyonu ve/veya egzersizin ağrı, postüral denge, uyku ve yaşam kalitesi üzerine etkileri: randomize kontrollü bir çalışma [The effects of instrument-supported soft tissue mobilization and/or exercise on pain, postural balance, sleep and quality of life in patients with chronic myofacial neck pain: a randomized controlled study]. J Tradit Complem Med. 2022;5(2):87-95. [Crossref] 
  23. Namalır N, Alptekin HK, Hatık SH, Binay Safer V, Öztürk B. Spesifik olmayan kronik bel ağrısında ev egzersizi, enstrüman destekli yumuşak doku mobilizasyonu ve enstrüman destekli spinal manipülasyon tedavi yöntemlerinin etkinliğinin araştırılması: randomize klinik çalışma [Investigation of the efficacy of home exercise, instrument assisted soft tissue mobilization and instrument assisted spinal manipulation treatment methods in non-specific chronic low back pain: randomized clinical trial]. Journal of Traditional Medical Complementary Therapies. 2021;4(3):318-25. [Crossref] 
  24. Crothers AL, French SD, Hebert JJ, Walker BF. Spinal manipulative therapy, Graston technique® and placebo for non-specific thoracic spine pain: a randomised controlled trial. Chiropr Man Therap. 2016;24:16. Erratum in: Chiropr Man Therap. 2016;24:31. [Crossref]  [PubMed]  [PMC] 
  25. Aydın E, Ural Nazlıkul F. Bel ağrısı olan hastalarda TENS'in ağrı ve yaşam kalitesi üzerine etkinliği: ön çalışma [The efficacy of TENS on pain and quality of life in patients with low back pain: a preliminary study]. Bilimsel Tamamlayıcı Tıp Regülasyon ve Nöral Terapi Dergisi. 2021;15(1):5-8. [Link] 
  26. Khadilkar A, Odebiyi DO, Brosseau L, Wells GA. Transcutaneous electrical nerve stimulation (TENS) versus placebo for chronic low-back pain. Cochrane Database Syst Rev. 2008;2008(4):CD003008. [Crossref]  [PubMed]  [PMC] 

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